Evaluation of wound healing, postoperative complications, and quality of life following impacted third molar extraction in hypothyroid patients undergoing medical hormone replacement therapy

Objective: Hypothyroidism is a common endocrine disorder that may affect wound healing processes in both soft and hard tissues. Impacted mandibular third molar extractions are among the most frequently performed surgical procedures in oral and maxillofacial surgery and are closely associated with postoperative complications such as pain, edema, and trismus. The aim of this study is to compare wound healing, postoperative complications, and quality of life parameters following impacted third molar extraction between hypothyroid patients who have achieved a biochemically euthyroid state under levothyroxine (LT4) therapy and systemically healthy individuals. Method: : A total of 37 patients who underwent mandibular third molar extraction between October 2024 and April 2025 were included. All surgeries were performed by the same surgeon using a standardized technique. Postoperative clinical healing parameters, quality of life, and radiographic assessments were compared between the two groups. Results: The study included 37 participants with similar age and sex distributions between groups. Postoperative pain, edema, and trismus peaked on the third day and subsequently decreased; values were higher in the hypothyroid group, but the differences were not statistically significant. Soft tissue and radiographic healing progressed faster in the control group, although these differences were also not statistically significant. Quality of life scores were highest on the third day in both groups and decreased over time, remaining higher in the hypothyroid group without reaching statistical significance. Conclusion: This study represents the first clinical investigation comparing healing after third molar extraction in hypothyroid patients rendered euthyroid with LT4 therapy and healthy individuals. The findings suggest that although LT4 therapy achieves systemic euthyroidism, it may not fully restore equality at the tissue level. Therefore, special attention is required in surgical planning and postoperative follow-up of hypothyroid patients. Further studies with larger sample sizes and longer follow-up periods are needed to confirm these findings. Key words: impacted third molar teeth, hypothyroidism, levothyroxine